Højlund Mikkel, Elliott Anja Friis, Madsen Nikolaj Juul, Viuff Anne Grethe, Munk-Jørgensen Povl, Hjorth Peter
a Department of Affective Disorders Research Unit , Aarhus University Hospital , Aarhus , Denmark.
b Psychiatric Research Academy , Mental Health Services Region of Southern Denmark , Odense , Denmark.
Nord J Psychiatry. 2017 Nov;71(8):598-604. doi: 10.1080/08039488.2017.1365379. Epub 2017 Aug 24.
Patients with schizophrenia have high risk of early death from diabetes and cardiovascular diseases, partly because of poor lifestyle and partly because of long-lasting exposure to antipsychotic treatment.
To investigate the influence of a lifestyle intervention program on changes in psychotropic medication in a non-selected cohort of patients with schizophrenia.
Observational study of outpatients in the Central Denmark Region during a 30-month lifestyle program.
One hundred and thirty-six patients were enrolled and 130 were available for analysis. Median follow-up time was 15.9 months (range 1-31 months). Nineteen patients (15%) were not treated with antipsychotic drugs during the study period. 54% of the 111 patients exposed to antipsychotics were subject to monotherapy at index and at follow-up. The median defined daily dose (DDD) of antipsychotics was 1.33 at index (interquartile range (IQR) 0.67-2.00) and 1.07 at follow-up (IQR 0.40-1.50). 52% of the patients experienced a decrease in DDD during the study period (median change 0.33; IQR 1.00-0.43). There were no significant differences between the patients with decreased, stable or increased DDD with regard to age, sex, follow-up time and time since diagnosis. The number of prescriptions was significantly higher in the patients who decreased their DDD and the proportion of antipsychotic depot formulation was higher in those who increased their DDD.
Most patients decreased or stabilized their total dose of antipsychotic medication during the study period. Many patients were subject to antipsychotic polypharmacy. The extent of participation in the lifestyle intervention program did not correlate with the changes in dosing of antipsychotic medication.
精神分裂症患者因糖尿病和心血管疾病导致过早死亡的风险较高，部分原因是生活方式不良，部分原因是长期接受抗精神病药物治疗。
在未经过挑选的精神分裂症患者队列中，研究生活方式干预计划对精神药物变化的影响。
对丹麦中部地区门诊患者进行为期30个月的生活方式计划的观察性研究。
共纳入136例患者，其中130例可供分析。中位随访时间为15.9个月（范围1 - 31个月）。19例患者（15%）在研究期间未接受抗精神病药物治疗。在111例接受抗精神病药物治疗的患者中，54%在基线和随访时接受单一疗法。抗精神病药物的中位限定日剂量（DDD）在基线时为1.33（四分位间距（IQR）0.67 - 2.00），随访时为1.07（IQR 0.40 - 1.50）。52%的患者在研究期间DDD下降（中位变化0.33；IQR 1.00 - 0.43）。DDD下降、稳定或增加的患者在年龄、性别、随访时间和诊断后时间方面无显著差异。DDD下降的患者处方数量显著更高，而DDD增加的患者中抗精神病长效制剂的比例更高。
在研究期间，大多数患者降低或稳定了抗精神病药物的总剂量。许多患者接受了抗精神病联合用药。生活方式干预计划的参与程度与抗精神病药物剂量的变化无关。
